STIs-What You Need To Know

Transcription

1 STIs: English STIs-What You Need To Know What are Sexually Transmitted Infections (STIs)? Sexually Transmitted Infections (STIs) are caused by a bacteria, virus, or parasite that is passed from one person to another during sex or intimate contact. How does someone get an STI? Most STIs are passed between sexual partners through unprotected oral, anal or vaginal sex or by sharing hands, fingers or sex toys. Some STIs are passed by skin-to-skin contact. Using condoms and other barriers for oral, anal and vaginal sex is a good way to lower the chances of passing many STIs. Find out more about safer sex. How do I know if I have an STI? You many not notice any symptoms when you have an STI. Sometimes the symptoms are easy to miss and/or they may last only a short time. Even when you don t notice any symptoms, you can still pass an STI to a sexual partner. The only way to know for sure if you have an STI is to get tested. What happens if I get an STI? If you are concerned that you might have an STI, get tested to find out for sure. Some STIs can cause serious health problems if left untreated. If your results come back positive (meaning you have an STI), your health care provider will tell you what kind of treatment you need. Many STIs can be cured with medication. A few can be managed with medications, but not cured. If you do have an STI, you may be asked about anyone that you have had sex with recently so that they can also be tested and treated if necessary. What can I do to protect myself and my partners from STIs? STIs are common infections and if you are sexually active, it is likely that you might have an STI at some time in your life. There are things you can do to lower the chances of getting an STI. Find out more on how to prevent STIs. Chlamydia What is Chlamydia? Chlamydia is a common sexually transmitted infection (STI) that affects men and women. It is caused by a type of bacteria which can easily go undetected as often people have no symptoms. If the infection goes untreated, a person with chlamydia risks health problems, particularly women. How does someone get Chlamydia? You can catch chlamydia by having unprotected anal, oral or vaginal sex, rimming, fingering or sharing sex toys. Find out how to prevent it. It s a very common STI and you or your most recent partner could have picked up the infection from a previous partner without even knowing it. The more sexual partners you have, the more chance you have of being infected. Ejaculation does not need to happen for the infection to be passed on. Most people with chlamydia don t experience any symptoms, so it is important to get tested even if you think you don t have something.

2 Symptoms of chlamydia can occur at any time after you have been infected, but they are more likely to show up between one and 28 days after sexual contact with someone who has the infection. Sometimes it s discovered when one partner develops symptoms, but more often it is diagnosed when someone goes for a check-up. If symptoms are present, these usually include: Penis: whitish discharge, discomfort, pain or burning when peeing. Testicles: pain and swelling in one or both testicles. Anus: itching, pain, discharge or bleeding. Mouth: a sore throat. Vagina: bleeding between periods and/or after or during sex. What does a chlamydia test involve? Testing for chlamydia is simple and painless. You will be asked to give a urine sample and you will have a swab of your throat and anus. Sometimes a swab of the penis may also be taken, if for example you have pain passing urine or a discharge from the penis. Sometimes you will be treated straight away, without waiting for the result of a chlamydia test, for example if your partner is known to have an infection or if you have symptoms. You will be given an antibiotic to take. This is often a single dose, all at once. Sometimes you will be given a longer course of antibiotics. This depends on the symptoms you have and where the infection is. Your health care provider will explain more to you about the best antiobiotic to use to treat your chlamydia. You ll be advised not to have sex, even with condoms, until 2 weeks after you (and your partner) have finished the treatment and you have no symptoms. You may be asked to return for another test after your treatment to confirm you have cleared the infection although this isn t usually needed for chlamydia infection. Gonorrhoea What is Gonorrhoea? Gonorrhoea or the clap is a common sexually transmitted infection (STI) caused by a type of bacteria. Infection usually occurs in the penis and anus but can also affect the throat and eyes. Untreated gonorrhoea poses a risk of passing the infection on to others and possible serious complications. For men, untreated gonorrhoea may lead to infection in the testes, causing pain and swelling, and in some cases infertility. How does someone get Gonorrhoea? You can catch gonorrhoea by having unprotected anal, oral or vaginal sex, rimming, fingering or sharing sex toys. Find out how to prevent it. Gonorrhoea is becoming much more common and you or your most recent partner could have picked up the infection from a previous partner without even knowing it. The more sexual partners you have, the more chance you have of being infected. Ejaculation does not need to happen for the infection to be passed on. Even without symptoms, gonorrhoea can still be passed on to others and cause painful problems and infertility, so it is important to get tested even if you think you don t have something. If you do notice the symptoms of gonorrhoea, they will usually show up between 1 to 14 days after coming into contact with the infection. In most cases, women are less likely to have symptoms than men. If symptoms are present, these usually include: Penis: green/yellow discharge, discomfort, pain or burning when peeing. Anus: discharge, itching, pain or bleeding. Anus: itching, pain, discharge or bleeding.

3 Mouth: a sore throat (although, this is not a common symptom). Eyes: discharge or red eye. What does a Gonorrhoea test involve? Testing for gonorrhoea is simple and painless. You will be asked to give a urine sample and you will have a swab of your throat and anus. Sometimes a swab of the penis may also be taken. Gonorrhoea infections are easily treated with a course of antibiotics usually consisting of one injection into the bum muscle and a single dose of tablets. Some gonorrhoea is becoming resistant to antibiotics. This can make it more difficult to treat. Sometimes you will be treated straight away, without waiting for the result of a gonorrhoea test, for example if your partner is known to have an infection or if you have symptoms. You will be advised not to have sex, even with condoms, until 2 weeks after you (and your partner) have finished the treatment and you have no symptoms. You will be asked to return for another test after your treatment to confirm you have cleared the infection. Syphilis What is Syphilis? Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria. Syphilis can be hard to spot and is one of the most easily caught sexually transmitted infections. If untreated it can cause serious health problems in both men and women. How does someone get Syphilis? You can catch syphilis by coming into direct contact with a syphilis sore; by having unprotected anal, oral or vaginal sex; rimming, fingering or sharing sex toys and through close genital contact. Find out how to prevent it. Syphilis spreads best by contact between moist skin areas anywhere on or in the body. People remain infectious to others for about two years from initial infection if they are not treated. Syphilis makes it easier for HIV to be transmitted, and sometimes having HIV can make syphilis harder to treat. Early syphilis is easy to miss. Many people show no sign that they re infected. Syphilis can make some people feel very ill, especially the secondary stage with a rash and fever. The third stage can develop many years after picking up the infection and can have very serious health consequences. It is best avoided by getting tested and treated. The best way to know if you have syphilis is to get tested. There are three stages to syphilis infection: 1.Primary Syphilis (Early Infectious Syphilis) 10 days to three months after you have been exposed a small, sore or ulcer (called a chancre) appears. The sore will appear on the part of your body where the infection was transmitted, typically the penis, anus, rectum, vagina, tongue or lips. Most people only have one sore, but some people have more. For many people, the sore is painless but not always. You may also experience swelling in your lymph glands (such as in the neck, groin or armpit). The sore will then disappear within two to six weeks and, if the condition is not treated, syphilis will move into its second stage. 2. Secondary Syphilis The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore.

4 At this stage common symptoms include: a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet tiredness headaches swollen lymph glands eye problems like pain or blurring of vision These symptoms may disappear within a few weeks, or come and go over a period of months. Syphilis will then move into a stage where you will experience no symptoms, even though you remain infected. This is called latent syphilis. You can still pass it on during the first year of this stage. However, after a couple of years, you cannot pass the infection to others, even though you remain infected. The latent stage can continue for many years (even decades) after you first become infected. Without treatment, there is a risk that latent syphilis will move on to the most serious stage tertiary syphilis. 3. Teritary Syphilis The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing a whole host of life limiting diseases. At this stage, untreated syphilis can be serious enough to cause death. This stage is best avoided by getting tested if you are at risk and getting treated early to avoid developing tertiary syphilis at a later stage, even many years later. What does a Syphilis test involve? Syphilis testing involves giving a sample of blood and sometimes it can involve taking a swab from a sore, if present. Getting tested is the only reliable way of knowing if you have syphilis or not. If you develop any of the symptoms of syphilis then go to your sexual health clinic as soon as possible, especially if you notice a sore on your genitals. The earlier syphilis is treated the better. If you are generally unwell and think you are at higher risk of syphilis, then get tested. Syphilis is treated with antibiotics (usually Penicillin). Treatment is usually given by injection and may involve one or more doses, depending on what kind of syphilis and the stage of the infection. Once the treatment has finished, further blood tests are carried out to make sure the infection has gone. These tests may be required at intervals for up to a year. These blood tests are important to monitor how well you have responded to treatment. Your partner(s) should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it. They may be offered treatment regardless. While you are being treated and until you get a clear test result: Do not have any kind of sex Avoid intimate contact with your partner and others This will stop you from infecting your partner if they are clear, and stop you being re-infected if they also have syphilis. Shigella What is Shigella? Shigella is a bacterium that causes severe stomach upset. How does someone get Shigella? It is passed on through infected faeces (poo) this can be through contaminated food or sexually. Only a very small amount of the bacteria is needed to cause infection. Infection can be treated with a course of antibiotics, however some strains can

5 prove more difficult to treat. Sex that may involve contact with faeces (poo) is a risk e.g. anal sex, fisting, fingering, rimming, oral sex or handling a condom or sex toy used for anal sex. Bad hygiene like not washing hands can contribute to the spread of shigella. The number of cases of sexually acquired Shigella has increased in MSM in the recent past in Europe, including Ireland. Shigella is a gut infection which causes severe, prolonged diarrhoea and stomach cramps. Symptoms often develop around one to three days after (sexual) contact, and can include: frequent and explosive diarrhoea lasting more than 48 hours stomach cramps feeling feverish with flu like symptoms some people report vomiting some people may have blood mixed with the diarrhoea What does a Shigella test involve? Shigella is usually diagnosed by sending a stool (poo) sample to the laboratory for testing. If you suspect you have Shigella, you should attend your healthcare provider who can organise this test. Diarrhoea caused by Shigella usually goes away between five to seven days. People with mild infection will generally get better with fluids and rest. Antibiotics are usually used to help reduce the spread of Shigella to someone else and for more severe cases. If you have diarrhoea, stomach cramps or fever, avoid sex with another person, till you get the all clear. If you have diarrhoea, stomach cramps or fever, avoid sex with another person, till you get the all clear. Do not share towels; avoid using health spas, jacuzzis, hot tubs or swimming pools. If you work in the food industry, healthcare or childcare settings, stay out of work while you have symptoms and seek medical care. LGV What is LGV? LGV stands for lymphogranuloma venereum, a type of chlamydia that has become more common in MSM since the early 2000 s. It is usually more severe than other types of chlamydia. How does someone get LGV? You can catch LGV by having unprotected anal, oral or vaginal sex, rimming, fingering or sharing sex toys with someone who has the infection. In Ireland, a high number of men diagnosed with LGV are also living with HIV however you don t have to be HIV positive to have LGV. If you experience any of the symptoms below, arrange a check-up with at your nearest sexual health clinic. Symptoms often develop around three days to three weeks after sexual contact. In MSM, it is mostly seen in the rectum but can include: Anus: Rectal inflammation, pain, discharge and blood. You may feel like you need to open your bowels all the time. Consti pation or diarrhoea may also occur. Penis: Painless blisters/sores, discharge, swelling in the groin area. Mouth: Sore throat, swollen glands in the neck. What does a LGV test involve? If you re a man who has sex with men with possible LGV symptoms, a sexual health clinic will use a swab to take a samples,

6 for example from your rectum. The samples are initially tested for chlamydia. If it tests positive it is then also tested for the chlamydia type that causes LGV. Treatment is with antibiotics for three weeks. Usually there are no lasting effects, as long as the infection is treated early enough. You will be advised not to have sex, even with condoms, until 3 weeks after you (and your partner) have finished the treatment and you have no symptoms. You will be asked to return for another test after your treatment to confirm you have cleared the infection. Genital Herpes What are Genital Herpes? Genital herpes is a sexually transmitted infection (STI), caused by a virus called herpes simplex virus (HSV). There are two slightly different types of the virus, both of which can affect the genitals. One of the types is exactly the same virus that causes cold sores around the mouth. Genital herpes causes painful blisters and sores on and around the genitals. How does someone get Genital Herpes? The herpes virus (HSV) is highly contagious and it can be easily passed from person to person by close, direct contact including kissing, vaginal and anal sex (genital contact), oral sex (mouth to genital contact) and sharing sex toys. Many people who have and pass on the virus may not even know they have herpes as it is possible to carry the virus without having any symptoms. Sometimes you can catch herpes when your sexual partner has no visible sores or symptoms. This is because the virus can become active on the skin without causing any visible blisters or sores. Many people with the herpes virus do not experience any symptoms when they are first infected and, as a result, do not know that they have it. If you do experience symptoms it usually takes between two and twelve days after contact with the virus for the first symptoms of genital herpes to appear. Although sometimes symptoms may not appear until months, or sometimes years, after you have been infected. Symptoms consist of multiple spots or red bumps around the genital area. These can be very painful. In time, these swellings can break open and form sores or ulcers which gradually crust over, forming new skin as they heal. Just like with cold sores, genital herpes can come back after the first episode. Is there a test for Genital Herpes? If you have visible blisters, the doctor or nurse may take a swab for testing and may also take a blood sample. When someone gets symptoms of genital herpes for the first time, treatment usually involves antiviral tablet to help speed up the healing process and sometimes painkillers. Sometimes after the first time the genital herpes can come back (recur), just like cold sores can come back. Sometimes people will need to take antiviral medication every day for 6 months to a year to reduce the number of recurrences. Other people who get recurrent episodes may just take the antiviral medication when they get symptoms. Your doctor will explain what may be the best option for you. If you start taking the medication as soon as an outbreak begins, you may shorten or even stop the episode.

7 Genital Warts What are Genital Warts? Genital warts are one of the most common sexually transmitted infections (STIs). Genital warts are usually painless and should not pose a serious threat to your health. They are caused by viruses from the human papilloma virus (HPV) family, and are similar to the warts you can get on other parts of the body. How does someone get Genital Warts? Genital warts can be spread by skin-to-skin contact such as anal sex. However, you do not need to have penetrative sex to pass the infection on because the virus is spread by skin-to-skin contact. Genital warts are similar to the warts you can get on other parts of the body such as the hands or feet. They usually occur between two or three months after exposure although they can occur up to a year after you have been infected. About 10% of people exposed to the virus will develop genital warts, so not everyone who has the virus will have visible warts. You may notice small, pinkish or white cauliflower-like lumps or warts, appearing singly or in groups around or inside the genital area. The warts may be itchy but are usually painless, although they will bleed if scratched so be careful. You might see or feel them yourself, or they may be noticed by your partner or during a medical examination. Is there a test for Genital Warts? The test for genital warts involves a simple examination of the genital area. There is no swab, urine or blood test currently available to look for the virus that causes the warts. If everything in your genital area looks and feels normal to you, then it is unlikely that you have genital warts. However, you could still carry the virus that causes them so if you develop symptoms then you should go back to your doctor or the sexual health service you attended. Treatments, which usually take place at sexual health clinics, include freezing, cutting or laser removal. These are carried out by a doctor or nurse. They may be uncomfortable, and may need to be repeated over several weeks to ensure the complete removal of the warts. Treatment often lasts between four and twelve weeks. It s important to remember that most treatments get rid of the warts themselves, but not the virus. So warts can recur until your body has cleared the virus. You may also be prescribed an anti-wart liquid or cream which can be used at home. Is there a Vaccine? A vaccine is available to men who have sex with men under the age of 26 and to all HIV positive men who have sex with men. You should ask a nurse or doctor at your sexual health clinic for more information. Hepatitis A What is Hepatitis A? Hepatitis A is a virus that infects the liver. It usually causes a mild illness and occasionally can lead to complications. Hepatitis A has been increasingly affecting men who have sex with men across Europe, including Ireland.

8 How does someone get Hepatitis A? Sexually acquired Hepatitis A is acquired by rimming and/or swallowing something that has been infected with faeces (poo). Most people notice no hepatitis symptoms at all especially in the early stages. What does a hepatitis A test involve? Testing for hepatitis A involves a blood test that looks for your body s reaction to the infections (antibodies). Treatment for Hepatitis A usually involves making sure that you are not dehydrated and your blood salts are okay, sometimes this involves having a drip of fluids into your vein in hospital. There is no specific treatment for hepatitis A and it usually clears on its own. Unlike hepatitis B and C, hepatitis A infection does not lead to long term liver problems and is rarely fatal. It can cause debilitating symptoms and very occasionally acute liver failure, which can be fatal. Is there a vaccine for Hepatitis A? Both hepatitis A and hepatitis B can be prevented with vaccination. The hepatitis A and B vaccines are freely available in sexual health services. Most centres use a combined vaccine given as three doses which protects you against both hepatitis A&B. Hepatitis B What is Hepatitis B? Hepatitis B is a virus that infects the liver. How does someone get Hepatitis? Hepatitis B can be is very infectious and is easily transmitted by all types of sex and by sharing needles. Hepatitis B can be avoided by getting tested and vaccinated. Many people notice no hepatitis symptoms at all especially in the early stages. However, some people get an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, pale faeces (poo), extreme fatigue, nausea, vomiting and abdominal pain. In a small number of people with acute illness they can develop liver failure, which can lead to death. This is rare. What does a hepatitis B test involve? To test for hepatitis B a blood test is taken. Your health care provider will ask for certain tests depending on your circumstances and explain what the results mean for you. Some people will naturally clear the virus. Others may have treatment which in some cases can clear the virus. If the infection remains (becomes chronic), long-term medication can manage symptoms and prevent long-term damage to health (for example cirrhosis of the liver or liver cancer). Is there a vaccine for Hepatitis B? Both hepatitis B and hepatitis A can be prevented with vaccination. The hepatitis vaccines are freely available in sexual health services. The vaccine is usually given over a period of months and usually involves three injections. You ll be asked to return after you have completed the course for a blood test to check how you have responded. Some people respond really well and never need to be checked again, some people respond less well and may need boosters in the future. A small number of people don t respond to the vaccine.

9 Hepatitis C What is Hepatitis C? Hepatitis C is a virus that infects the liver. How does someone get Hepatitis? Hepatitis C is much harder to catch through sex than hepatitis A or B but is becoming more common among men who have sex with men. You can get Hepatitis C when infected blood finds its way into your bloodstream (blood-to-blood contact). This might happen through activities like fisting, double penetration, prolonged sexual activity with multiple partners. Sharing needles is the main route of transmission. Following initial infection, about 8 out of 10 people do not have any symptoms. Those who have symptoms may experience fever, tiredness, decreased appetite, nausea, vomiting, abdominal pain, dark urine, pale faeces (poo), joint pain and jaundice (yellowing of skin and the whites of the eyes). If not diagnosed early and treated Hepatitis C can lead to severe liver problems like cirrhosis or liver cancer years after infection. It is important to get tested for Hepatitis C if you have been at risk. What does a hepatitis C test involve? To test for viral hepatitis a blood test is carried out to look for any antibodies to the virus which have been produced in response to an infection. If these are present, then you have been in contact with the virus/infected at some time. In the case of hepatitis C, the lab will then look for the actual virus to determine if you are actively carrying the virus Hepatitis C can be treated with anti-viral medications. There are different types of medications, some are taken as a tablet and others are given as injections. Current Hepatitis C medication is very effective at curing the infection but it can take weeks to months to treat, is extremely expensive, and the side effects of the medication can be unpleasant. Is there a vaccine for Hepatitis C? There is currently no vaccination available to prevent Hepatitis C. Prevention of Hepatitis C relies on having safer sex and not sharing needles. Pubic Lice (Crabs) What are Public Lice (Crabs)? Pubic lice, also known as crabs, are tiny insects that live in body hair and are spread by close physical contact. They are just like head lice, only they are in pubic and body hair, not head hair. How does someone get Public Lice (Crabs)? They are spread through close body contact with someone who has them. The lice crawl from hair to hair but cannot fly or jump. They need human blood to survive, so generally only leave the body to move from one person to another. They do not live on other animals such as cats or dogs. Pubic lice are most commonly passed on during sexual contact. Condoms will not prevent them from being passed to another person. It is not a reflection of an individual s personal hygiene. It is also possible for pubic lice to be spread through sharing clothes, towels and bedding.

10 The most common symptom of pubic lice is intense itching. The itching is caused by an allergy to the droppings of the louse. It can take one to three weeks for itching to develop after they infest, and it will usually be worse at night. Adult pubic lice are tiny smaller than a match head. They are grey-brown in colour and have six legs. The two pairs of back legs are much larger and look like the pincer claws of a crab (hence the name!). They use these to grasp onto your hair. Pubic lice eggs are tiny, yellow-white ovals, which are stuck firmly to the base of your hairs. Is there a test for Pubic Lice (Crabs)? There is no test for lice, but you ll likely see the lice crawling in your body hair. Your GP or sexual health clinic can also look for visible evidence of the lice. Pubic lice can be treated at home with insecticidal lotion or cream that you can get over the counter in your local pharmacy. You will usually need to apply the treatment once and repeat again after seven days. Everyone that you have had close body contact with should be treated at the same time. You will also need to wash all your bedding and clothes on a hot wash. Scabies What are Scabies? Scabies are tiny parasitic mites. They are smaller than a pinhead and burrow into the skin and lay eggs. They are passed on by close body contact. How does someone get Scabies? The mites that cause scabies can be found in the genital area, on the hands, between the fingers, on the wrists and elbows, underneath the arms, on the stomach, on the feet and ankles, and around the bum. The mites can live for up to 72 hours off the body, so it is possible for scabies to be spread by clothing, bedding and towels. It can take up to six weeks after coming into contact with scabies before signs and symptoms appear. You might notice: Intense itching in the affected areas which may only be noticed at night, or which becomes worse in bed at night or after a hot bath or shower. An itchy red rash or tiny spots. Sometimes the diagnosis can be difficult because the rash can look like other itchy conditions, such as eczema. Inflammation or raw, broken skin in the affected areas usually caused by scratching. Is there a test for Scabies? Scabies mites are very tiny and impossible to see with the naked eye. Fine silvery lines are sometimes visible in the skin where mites have burrowed. A doctor or nurse can often tell if you have scabies just by looking at the affected areas. They may gently take a skin flake from one of the areas and look at it under a microscope to see if there is a mite present. In some cases, treatment will be suggested if scabies is suspected, even if it cannot be confirmed. Treatment is simple and involves using a special cream or lotion. The doctor, nurse or pharmacist will advise you on what treatment to use and how to use it. You will usually need to apply the treatment once and repeat again after seven days. Everyone that you have had close body contact with should be treated at the same time.

11 You should wash clothing, bedding and towels in a washing machine on a very hot cycle (50 C higher) to kill the mites and avoid re-infection. Even after successful treatment, the itching or rash may continue for a few weeks. Special tablets or creams (antihistamines), or anti-irritant lotions such as calamine, can ease the itching. Non-Specific Urethritis (NSU) What is NSU? NSUs is inflammation (pain, redness and/or swelling) of the urethra (tube where urine comes out). How does someone get NSU? There are many different causes. Some, but not all, are passed on through having sex. If you have non-specific urethritis there may be more than one cause, and in some men a cause is never identified. Examples are: Bacterial infections like chlamydia Damage to the urethra (rough sex, vigorous masturbation, etc.) Exposure to faecal matter (poo) during anal intercourse General sensitivity / allergic reaction Not all men who have inflammation will show any signs or symptoms, or they may be so mild they are not noticed. If signs and symptoms do occur they usually show up within 2 4 weeks of contact with an infection, but they can sometimes appear within a day or two (depending on the cause of the inflammation). If you do get signs and symptoms you might notice: A white or cloudy discharge from the tip of the penis, usually more noticeable first thing in the morning. Difficulty, pain or a burning sensation when passing urine. The feeling that you need to pass urine frequently. Itching or irritation at the end of the urethra. Depending on the cause of the inflammation there may also be other symptoms that are specific to particular infections. Is there a test for NSU? The tests involves a doctor or nurse using a swab to collect a sample of cells from the entrance of the urethra (tip of the penis). You will also be asked to give a urine sample. Some men may get non-specific urethritis more than once, and for a few men it may keep coming back. If this happens, you may be given a second course, or a combination, of antibiotics. Your healthcare provider will explain the treatment to you.